Patients who have a documented abnormal first trimester pregnancy will be randomly assigned to receive either misoprostol or placebo vaginally. Patients return two days later for a vaginal ultrasound and a second dose of the medication if the pregnancy has not passed. Those who receive a second dose will be followed two days later. Patients who have not passed the pregnancy after two doses of placebo will be referred for either surgical abortion or treatment with misoprostol as they prefer. Patients who pass the pregnancy under the study protocol will be followed two weeks later and then weekly until their HCG levels fall below 10. NCRR Clarification: research is on abnormal pregnancy/miscarriage